Nursing –Module 1 Short Answer Questions
- In a couple of sentences, outline why it is difficult to distinguish between clinical-decision making errors solely due to intuitive judgment or analytical judgment.
The problem lies in the fact that both methods have their ups and downs. Specifically, errors in an analytical judgment happen because the patient may not be diagnosed in time due to being meticulous. While being meticulous about a diagnosis is advised and should happen, this is not always the case. As such intuitive judgment of the issue is now used. While this is faster, it does not guarantee a correct diagnosis. Now, given that the diagnosis in an emergency should be rapid, this is when errors come into play. We cannot simply assume that the error lies in the judgment call of the person on the scene as there are many aspects that are in play. The number of patients, the number of clinical staff, the number of cases, the situation of the surroundings, the mental and physical state of the clinical staff and so forth. Thus the error lays in many factors not just the judgment call. Take for instance the strengths that both analytical and intuitive judgments have. There’s a reason why you get a “gut feeling” when you do make an intuitive judgment call, you’ve already seen it before. You could be wrong yes, but you know there’s a good reason why you think you’re right.
- Current literature points to a debate surrounding the reliability of intuitive clinical reasoning in comparison to the analytical, hypothetical, deductive process of reasoning discuss and debate current findings.
- Why is clinical reasoning a bounded process? Discuss.
Clinical reasoning is the bread and butter of any medical practitioner. It is bounded because it requires certain aspects and traits such as knowledge of the field, applied cognition for evaluating and managing a patient’s medical problem, and most importantly, it is also contextually bound. Contextually bound as all reasons placed forward must be for the treatment of the patient . It is a process because it requires anyone who uses it to go through certain steps. Steps that include problem solving, decision making, clinical judgment, decision making and critical thinking which can be used in any order. Medical practitioners with clinical reasoning skills more often have a positive outcome when it comes to a patients care. More importantly, clinical reasoning is a bounded process because a medical practitioner will have more than just one session with a patient. It is “bounded” by the fact that said steps must always be applied during every session with the patient and more often than not, it will always yield a different result every time. To be more precise the exact process that a medical practitioner has to follow are the following:
- Consider the patient’s situation
- Collect cues and information
- Process information
- Identify problems or issues
- Establish goals
- Take action
- Evaluate outcome
Once all of this is said and done, the process begins again at step number one . These steps must be followed to the letter as each step is a process in itself and cannot work if they are interchanged. While the concepts behind this process are still evolving, the process itself has proven to be well made and well done. As the process itself is based on cognition, it is specifically tailored to help medical practitioners treat patients without making them feel uneasy. However, when the process itself is being scrutinized using the scientific-method, it fails to label the process in first process terms of experience and consciousness . While there are steps to the process of clinical reasoning, to date there is still no model that captures the essence of the complexity of clinical reasoning . As the clinical reasoning process is a personal practice best understood by practical application rather than theoretical discussion, a practitioner will better understand why the process is bounded if and when they start using it themselves. Since the process uses mostly cognitive concepts of psychology and the likes, it is really up to the practitioner to find out where his or her patient lies within the spectrum of human interaction and how he or she will deal with them. As step number one points out “consider the patient’s situation”, this can be interpreted as more than just understanding the disease that has inflicted the patient, but also understand the position of the patient himself or herself. This of course is not meant to raise pity in the practitioner, but rather, to simply give them a better understanding of how to help the patient.
References
Anonymous. (2012). Clinical Decision Making Lecture. Flinders university.
Atkinson, K., Ajjawi, R., & Cooling, N. (September 2011). Promoting clinical reasoning in general practice trainees: role of the clinical teacher.
Audétat, M.-C., Laurin, S., Sanche, G., Béïque, C., Fon, N. C., Blais, J.-G., et al. (March 2013). Clinical reasoning difficulties: A taxonomy for clinical teachers.
Braude, H. D. (October 2012). Conciliating cognition and consciousness: the perceptual foundations of clinical reasoning.
Charlin, B., Lubarsky, S., Millette, B., Crevier, F., Audétat, M.-C., Charbonneau, A., et al. (2006). Clinical reasoning processes: unravelling complexity through graphical representation.
McGregor, C. A., Paton, C., Thomson, C., Chandratilake, M., & Scott, H. (July 2012). Preparing medical students for clinical decision making: A pilot study exploring how students make decisions and the perceived impact of a clinical decision making teaching intervention.
Smith, J. (2009). Clinical Reasoning: Instructor Resources. University of Newcastle.
